| Shah Wellness Medical Clinic Inc. | |
|
23341 Golden Springs Dr Suite 210 Diamond Bar CA 91765-2058 | |
| (909) 860-2610 | |
| (909) 860-1192 |
| Full Name | Shah Wellness Medical Clinic Inc. |
|---|---|
| Speciality | General Practice |
| Location | 23341 Golden Springs Dr, Diamond Bar, California |
| Authorized Official Name and Position | Hitendra H Shah (PRESIDENT) |
| Authorized Official Contact | 9098602610 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Shah Wellness Medical Clinic Inc. 23341 Golden Springs Dr Suite 210 Diamond Bar CA 91765-2058 Ph: (909) 860-2610 | Shah Wellness Medical Clinic Inc. 23341 Golden Springs Dr Suite 210 Diamond Bar CA 91765-2058 Ph: (909) 860-2610 |
| NPI Number | 1720486822 |
|---|---|
| Provider Enumeration Date | 12/05/2014 |
| Last Update Date | 12/05/2014 |
| Medicare PECOS PAC ID | 9234401241 |
|---|---|
| Medicare Enrollment ID | O20200121000943 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720486822 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | A36638 (California) | Primary |
| Provider Name | Hitendrah H Shah |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1376614818 PECOS PAC ID: 2365419629 Enrollment ID: I20040916000407 |
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